Assessing the Potential Impact of the Affordable Care Act on Uninsured Community Health Center Patients

This brief estimates the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. The authors find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients would be eligible for coverage. However, over one million uninsured patients – 72 percent of whom live in southern states – who would have been eligible for coverage will remain uninsured because of states’ decisions to opt out of the expansion. The spillover effects of the decision to opt out of the Medicaid expansion are likely to be significant. Health centers in opt-out states can be expected to struggle, falling further behind their expansion state counterparts in terms of service capacity, number of patients served (both insured and uninsured), and in their ability to invest in initiatives that improve the quality and efficiency of health care.